scholarly journals Migraine Screening in Primary Eye Care Practice: Current Behaviors and the Impact of Clinician Education

2020 ◽  
Vol 60 (8) ◽  
pp. 1817-1829
Author(s):  
Bao N. Nguyen ◽  
Sumeer Singh ◽  
Laura E. Downie ◽  
Allison M. McKendrick
Keyword(s):  
Care Practice ◽  
Eye Care ◽  
Primary Eye Care ◽  
Clinician Education ◽  
The Impact

Use of Remote Optometric Vision Therapy in a Primary Eye Care Practice

2020 ◽  
pp. 99-106
Keyword(s):  
Patient Selection ◽  
Parental Support ◽  
Care Practice ◽  
Eye Care ◽  
Technical Requirements ◽  
Online Platforms ◽  
Case Selection ◽  
Home Based ◽  
Vision Therapy ◽  
Office Procedures

Many optometrists supplement office-based vision therapy with home-based vision therapy procedures. Others prescribe primarily home-based vision therapy activities with in-office instruction. With recent development of telehealth online platforms, it is possible to enhance home-based vision therapy with one-on-one doctor-guided and vision therapist-guided remote optometric vision therapy (ROVT). This may increase access for times when the patient is not able to present to the office. Procedures for implementing ROVT are discussed including patient selection, case management, and technical requirements. 35 patients received ROVT, with the vast majority responding positively. Three cases of ROVT are presented. While there are significant limitations to ROVT, this experience shows that it is possible to conduct ROVT when there is need. We found that case selection and parental support at home are important factors for success.

scholarly journals An Effectiveness Trial of STEADI in an Outpatient, Primary Care Practice

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 774-774
Author(s):  
David Rein ◽  
Madeleine Hackney ◽  
Michele Dougherty ◽  
Camille Vaughan ◽  
Laurie Imhof ◽  
...  
Keyword(s):  
Primary Care ◽  
Medication Review ◽  
Primary Care Practice ◽  
Controlled Trial ◽  
Care Practice ◽  
Strength Assessment ◽  
Randomized Controlled ◽  
Study Team ◽  
One Year ◽  
The Impact

Abstract The STEADI Options trial uses a randomized, controlled-trial design to assess the effectiveness and cost-effectiveness of the STEADI Initiative . Beginning March, 2020, we will randomize 3,000 adults ≥ 65 years of age at risk for falls seen in an Emory Clinic primary care practice to: (1) full STEADI; (2) a STEADI-derived gait, balance, and strength assessment with physical therapy referrals; (3) a STEADI-derived medication review and management; or (4) usual care. This presentation will discuss decisions made by the study team to facilitate implementation of STEADI including electronically conducting screening prior to the date of encounter, the use of dedicated nursing staff to conduct assessments, implementation of strength, balance, orthostatic hypotension, and vision testing, methods to facilitate medication review, and communication of assessment information to providers. The results from this study will be used to estimate the impact of STEADI on falls, service utilization, and costs over one year.

scholarly journals Relation of severe COVID-19 in Scotland to transmission-related factors and risk conditions eligible for shielding support: REACT-SCOT case-control study

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul M. McKeigue ◽  
David A. McAllister ◽  
David Caldwell ◽  
Ciara Gribben ◽  
Jen Bishop ◽  
...  
Keyword(s):  
General Population ◽  
Rate Ratio ◽  
Conditional Logistic Regression ◽  
Population Attributable Risk ◽  
Case Control ◽  
Care Practice ◽  
Solid Organ ◽  
Related Factors ◽  
Recent Exposure ◽  
The Impact

Abstract Background Clinically vulnerable individuals have been advised to shield themselves during the COVID-19 epidemic. The objectives of this study were to investigate (1) the rate ratio of severe COVID-19 associated with eligibility for the shielding programme in Scotland across the first and second waves of the epidemic and (2) the relation of severe COVID-19 to transmission-related factors in those in shielding and the general population. Methods In a matched case-control design, all 178,578 diagnosed cases of COVID-19 in Scotland from 1 March 2020 to 18 February 2021 were matched for age, sex and primary care practice to 1,744,283 controls from the general population. This dataset (REACT-SCOT) was linked to the list of 212,702 individuals identified as eligible for shielding. Severe COVID-19 was defined as cases that entered critical care or were fatal. Rate ratios were estimated by conditional logistic regression. Results With those without risk conditions as reference category, the univariate rate ratio for severe COVID-19 was 3.21 (95% CI 3.01 to 3.41) in those with moderate risk conditions and 6.3 (95% CI 5.8 to 6.8) in those eligible for shielding. The highest rate was in solid organ transplant recipients: rate ratio 13.4 (95% CI 9.6 to 18.8). Risk of severe COVID-19 increased with the number of adults but decreased with the number of school-age children in the household. Severe COVID-19 was strongly associated with recent exposure to hospital (defined as 5 to 14 days before presentation date): rate ratio 12.3 (95% CI 11.5 to 13.2) overall. The population attributable risk fraction for recent exposure to hospital peaked at 50% in May 2020 and again at 65% in December 2020. Conclusions The effectiveness of shielding vulnerable individuals was limited by the inability to control transmission in hospital and from other adults in the household. Mitigating the impact of the epidemic requires control of nosocomial transmission.

scholarly journals The optometrist and primary eye care

1997 ◽  
Vol 81 (2) ◽  
pp. 100-101 ◽  
Author(s):  
A EWBANK
Keyword(s):  
Eye Care ◽  
Primary Eye Care

Evaluation of Targeted Pharmacist Interventions to Reduce Length of Stay in an Acute Care Practice Model

2018 ◽  
Vol 53 (5) ◽  
pp. 471-477 ◽  
Author(s):  
Mary-Haston Leary ◽  
Kathryn Morbitzer ◽  
Bobbi Jo Walston ◽  
Stephen Clark ◽  
Jenna Kaplan ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Acute Care ◽  
Positive Impact ◽  
Pharmacy Practice ◽  
Care Practice ◽  
Readmission Rates ◽  
A Value ◽  
Pharmacist Interventions ◽  
Semistructured Interviews ◽  
The Impact

Background: Despite widespread recognition of the need for innovative pharmacy practice approaches, the development and implementation of value-based outcomes remains difficult to achieve. Furthermore, gaps in the literature persist because the majority of available literature is retrospective in nature and describes only the clinical impact of pharmacists’ interventions. Objective: Length of stay (LOS) is a clinical outcome metric used to represent efficiency in health care. The objective of this study was to evaluate the impact of pharmacist-driven interventions on LOS in the acute care setting. Methods: A separate samples pretest-posttest design was utilized to compare the effect of pharmacist interventions across 3 practice areas (medicine, hematology/oncology, and pediatrics). Two time periods were evaluated: preimplementation (PRE) and a pilot period, postimplementation of interventions (POST). Interventions included targeted discharge services, such as discharge prescription writing (with provider cosignature). Participating pharmacists completed semistructured interviews following the pilot. Results: A total of 924 patients (466 PRE and 458 POST) were included in the analysis. The median LOS decreased from 4.95 (interquartile range = 3.24-8.5) to 4.12 (2.21-7.96) days from the PRE versus POST groups, respectively ( P < 0.011). There was no difference in readmission rates between groups (21% vs 19.1%, P = 0.7). Interviews revealed several themes, including positive impact on professional development. Conclusion and Relevance: This pilot study demonstrated the ability of pharmacist interventions to reduce LOS. Pharmacists identified time as the primary barrier and acknowledged the importance of leaders prioritizing pharmacists’ responsibilities. This study is novel in targeting LOS, providing a value-based outcome for clinical pharmacy services.

Economic Analysis of Primary Eye Care Services Provided through Vision Centers in Eastern India

2019 ◽  
Vol 26 (6) ◽  
pp. 439-447
Author(s):  
Prem Kumar SG ◽  
Sandip Banerjee ◽  
Sushami Pal ◽  
Sabitra Kundu ◽  
Sukanta Mishra ◽  
...  
Keyword(s):  
Economic Analysis ◽  
Eastern India ◽  
Eye Care ◽  
Primary Eye Care ◽  
Care Services

Immigration and Contract Problems Experienced by Foreign-Educated Nurses

2012 ◽  
Vol 69 (3) ◽  
pp. 351-365 ◽  
Author(s):  
Patricia Pittman ◽  
Carolina Herrera ◽  
Joanne Spetz ◽  
Catherine R. Davis
Keyword(s):  
United States ◽  
Health Care ◽  
Low Income ◽  
The United States ◽  
Low Income Countries ◽  
Labor Rights ◽  
Care Practice ◽  
Quality Health Care ◽  
International Recruitment ◽  
The Impact

More than 8% of employed RNs licensed since 2004 in the United States were educated overseas, yet little is known about the conditions of their recruitment or the impact of that experience on health care practice. This study assessed whether the labor rights of foreign-educated nurses were at risk during the latest period of high international recruitment: 2003 to 2007. Using consensus-based standards contained in the Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Health Professionals to the United States, this study found 50% of actively recruited foreign-educated nurses experienced a negative recruitment practice. The study also found that nurses educated in low-income countries and nurses with high contract breach fees, were significantly more likely to report such problems. If, as experts believe may occur, the nursing shortage in the United States returns around 2014, oversight of international recruitment will become critically important to delivering high-quality health care to Americans.

scholarly journals Combating Grade Inflation in Nephrology Clinical Rotation Evaluations Using Faculty Education and a 5-Point Centered Rating Scale

2016 ◽  
Vol 8 (2) ◽  
pp. 191-196
Author(s):  
Christina M Yuan ◽  
Robert Nee ◽  
Kevin C Abbott ◽  
James D Oliver
Keyword(s):  
Rating Scale ◽  
Medical Knowledge ◽  
Grade Inflation ◽  
Likert Scale ◽  
Faculty Members ◽  
Care Practice ◽  
First Year ◽  
Clinical Rotation ◽  
Likert Scales ◽  
The Impact

ABSTRACT  From 2010 to 2011, more than 70% of the clinical rotation competency evaluations for nephrology fellows in our program were rated “superior” using a 9-point Likert scale, suggesting some degree of “grade inflation.”Background  We sought to assess the efficacy of a 5-point centered rotation evaluation in reducing grade inflation.Objective  This retrospective cohort study of the impact of faculty education and a 5-point rotation evaluation on grade inflation was measured by superior item rating frequency and proportion of evaluations without superior ratings. The 5-point evaluation centered performance at the level expected for stage of training. Faculty education began in 2011–2012. The 5-point centered evaluation was introduced in 2012–2013 and used exclusively thereafter. A total of 68 evaluations, using the 9-point Likert scale, and 63 evaluations, using the 5-point centered scale, were performed after first-year fellow clinical rotations. Nine to 12 faculty members participated yearly.Methods  Faculty education alone was associated with fewer superior ratings from 2010–2011 to 2011–2012 (70.5% versus 48.3%, P = .001), declining further with 5-point centered scale introduction (2012–2013; 48.3% versus 35.6%; P = .012). Superior ratings declined with 5-point centered versus 9-point Likert scales (37.3% versus 59.3%, P = .001), specifically for medical knowledge, patient care, practice-based learning and improvement, and professionalism. On logistic regression, evaluations without superior scores were more likely for 5-point centered versus 9-point Likert scales (adjusted odds ratio [aOR] = 8.26; 95% CI 1.53–44.64; P = .014) and associated with faculty identifier (aOR= 1.18; 95% CI 1.03–1.35; P = .013), but not fellow identifier or training year quarter.Results Conclusions  Grade inflation was reduced with faculty education and the 5-point centered evaluation scale.

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